Cathy Jean Gourley, MA, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Boonville, IN

NPI 1194809434 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1194809434
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
22003247A (IN)
Practice address
1601 S Rockport Rd
Boonville, IN 47601-9708
Phone
(812) 897-8730
Fax
(812) 897-8730
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
22003247AINMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22003247A IN Yes

Addresses

Primary practice location

1601 S Rockport Rd
Boonville, IN 47601-9708

Mailing address

1601 S Rockport Rd
Boonville, IN 47601-9708
Phone (812) 897-8730

Other providers in Boonville, IN

All providers in Boonville, IN · Speech-Language Pathologist in Indiana

Sources for this page

Verify at the official NPI Registry.